1 April 2017

Although generally not eating in a manner consistent with dietary guidelines, the CSIRO’s 2016 study comparing the 1995 and 2011 national nutrition survey results found some positive changes in what Australians are consuming.

What’s up? Whole fruit, a greater diversity of vegetables, more beans, peas and pulses, less refined sugar, and increased their preference for brown and wholegrain cereals. Adult Australians also increased their intake of nuts and seeds. But on a less positive note, they also drank more wine (+44%). And both young and old tucked into lots more cocoa products (aka chocolate) – 32% more for younger Australians and 84% more for adults.

What’s down? Added sugar and butter. The reduced intake of added sugar is partly explained by a decrease in per capita consumption of sugar sweetened beverages in Australia over time. Fruit juice consumption also markedly declined, especially for younger Australians.

Too much sugar and too few nuts are killing us, apparently. That’s how press reports distilled a recent paper in the Journal of the American Medical Association. Hype and fear about good and bad foods probably does more harm than good. Emphasizing a single food or nutrient in isolation seldom leads to better health. What does work is to pay attention to overall dietary patterns. If you have real concerns about your health and nutrition, the best help comes from working with a smart dietitian.
Inconvenient Facts About Australia’s Sugar Consumption

The facts simply don’t support such a simple “too much sugar” story. A new study in the American Journal of Clinical Nutrition finds in Australia, 4 independent data sets confirmed shorter- and longer-term declines in the availability and intake of added sugars, including those contributed by SSBs (sugar sweetened beverages). The findings challenge the widespread belief that energy from added sugars or sugars in solution are uniquely linked to the prevalence of obesity. Co-author Dr Alan Barclay says that people have been listening to guidelines in Australia. Those guidelines have, since 1980, been telling people to limit sugar. These data suggest they’ve been doing just that. But the population has been increasing its intake of confectionary (chocolate especially) and alcohol. So, simply demonizing or taxing sugar sweetened beverages might not solve the problem of obesity.

In Praise of Nuts

On the other side of the equation, exalting the life-saving virtues of eating more nuts might help the nut growers ring up more sales. But it probably won’t extend our lives. And that headline about “too few nuts” is grossly misleading. In the context of a healthy dietary pattern, like a Mediterranean diet, nuts contribute to good health. By themselves, not so much. – Thanks to Ted Kyle of ConscienHealth http://conscienhealth.org/ for this report.

Studies: For the paper in AJCN, click here. The JAMA study of dietary patterns is here, along with a worthwhile commentary here.

GLUTEN-FREE FAD DIETS MIGHT HAVE A DIABETES DOWNSIDE

For millions of people who don’t really need a gluten-free diet, eating less gluten might have a downside. Research presented at the AHA EpiLifestyle meeting yesterday found that people who ate less gluten had a slightly higher risk of developing type 2 diabetes. The investigators found no difference in the risk of weight gain.

A gluten-free diet is a no-brainer for someone with celiac disease or confirmed non-celiac gluten sensitivity (gluten intolerance). But gluten-free fad diets have reached far beyond folks with actual gluten sensitivity or celiac disease. Some people falsely believe it will help them lose weight or magically give them better health. This new data is a useful reminder that food fads can have a downside and becoming fixated on demonizing a particular food or nutrient can lead to surprises down the road.

This research does not prove that gluten-free diets cause diabetes. All these data show is an association, not a cause and effect relationship. Maybe gluten helps to lower diabetes risk. Or maybe people who avoid gluten eat less fiber. But it’s equally possible that something else is confounding these findings. Sorting those questions out will require more definitive research. Until then, avoid gluten if you must. But unless you have a confirmed sensitivity, cutting gluten is pointless. In fact, it limits your choices for whole grains. And whole grains have real benefits for health. Thanks to Ted Kyle of ConscienHealth for this report

Studies: For the abstract of this study, click here. Further perspectives, click here and here.

REVERSING DIABETES

“While type 2 diabetes cannot be cured as such, it can be put in to remission in people who have been newly diagnosed. We use the word ‘remission’ rather than ‘cure’ because diabetes may return years later, either due to people slowly regaining weight or simply due to advancing age,” says Dr Alan Barclay in Reversing Diabetes (Murdoch Books).

Clinical trials show that around one in eight people can put type 2 diabetes into remission for between 2 and 10 years by losing a significant amount of body weight following a healthy lifestyle.

In the medium to long term (2 to 5 years), bariatric surgery is more effective than lifestyle interventions, helping between three and seven out of 10 people to go into remission.

A review of clinical trials has shown that short-term (2 to 3 weeks) use of insulin by those newly diagnosed with type 2 diabetes can cause medium-term (2 years) remission in about four out of 10 people.

The Diabetes Research Group in Newcastle (UK) used magnetic resonance spectroscopy and imaging to explain the abnormal storage of fat and glycogen in pancreas, liver and muscle in type 2 diabetes. Too much fat within liver and pancreas prevents normal insulin action and prevents normal insulin secretion. Both defects are reversible by substantial weight loss. A crucial point is that individuals have different levels of tolerance of fat within liver and pancreas. Only when a person has more fat than they can cope with does type 2 diabetes develop. In other words, once a person crosses their personal fat threshold, type 2 diabetes develops. Once they successfully lose weight and go below their personal fat threshold, diabetes will disappear.

The group’s current DiRECT study is a cluster randomised controlled trial to find out how well reversal of type 2 diabetes works when done by Practice Nurses in General Practice in the UK. It will also investigate how durable the return to normal glucose control is, how people cope with the programme and what underlying changes in liver and pancreas determine outcome. If you want to find out more about it, visit the DiRECT website.